In the US, pharmacy benefit management companies serve as intermediaries between health insurers, pharmacies, and patients. They primarily focus on negotiating drug prices, managing prescription benefits, and improving medication adherence. The industry has evolved significantly, with many firms leveraging technology and data analytics to enhance service delivery. As healthcare costs continue to rise, pharmacy benefit managers are under pressure to provide cost-effective solutions while maintaining access to essential medications. With a growing emphasis on transparency and patient satisfaction, these companies are adapting to changing needs and exploring innovative ways to integrate healthcare services more efficiently.

This list features 22 pharmacy benefit management companies, varied in size and geographic presence. They range from large employers with over 10,000 staff to smaller firms with under 500 employees. Established between 1926 and 2020, these companies specialize in different areas of pharmacy management, offering services such as specialty pharmacy, claims processing, and medication therapy management. Most are headquartered in major US cities, showcasing a blend of innovation and operational excellence.

Read on to discover the top pharmacy benefit management companies in the US.

Top 22 Pharmacy Benefit Management Companies in the US

1. Express Scripts by Evernorth

• Website: express-scripts.com
• Ownership type: Corporate
• Headquarters: St. Louis, Missouri, United States (USA)
• Employee distribution: United States (USA) 98%, Other 2%
• Latest funding: $67.0B, March 2018
• Founded year: 1986
• Headcount: 10001+
• LinkedIn: express-scripts

Express Scripts by Evernorth, based in St. Louis, Missouri, is a prominent pharmacy benefit management company that has been operational since 1986. The company specializes in providing integrated pharmacy services tailored to health plans, employers, and government agencies. Their services include claims processing, home delivery pharmacy, and specialty pharmacy management, all aimed at facilitating efficient access to medications while managing costs effectively. With over 13,000 employees, Express Scripts has a robust infrastructure to support its operations. The company has also received substantial funding, amounting to $67 billion, which underscores its financial backing and capacity for growth. Express Scripts is committed to enhancing the medication experience for its clients, offering features like 24/7 customer support and a user-friendly mobile app for managing prescriptions.

2. Optum

• Website: optum.com
• Ownership type: Private
• Headquarters: Eden Prairie, Minnesota, United States (USA)
• Employee distribution: United States (USA) 49%, India 41%, Philippines 5%, Other 5%
• Founded year: 2011
• Headcount: 10001+
• LinkedIn: optum

Optum, Inc., founded in 2011 and based in Eden Prairie, Minnesota, is a healthcare services provider that offers a wide range of solutions, including technology services, consulting, and pharmacy care. With over 93,000 employees globally, Optum serves various stakeholders in the healthcare ecosystem, including employers, health plans, and government agencies. A significant part of their operations is Optum Rx, which specializes in pharmacy benefits management. This division provides services such as home delivery and specialty pharmacy, aiming to improve health outcomes and manage costs effectively. Optum leverages data analytics and clinical expertise to tailor their pharmacy programs, ensuring that clients receive both cost savings and enhanced patient experiences. Their commitment to innovation in healthcare solutions makes them a notable entity in the pharmacy benefit management industry.

3. MedImpact Healthcare Systems, Inc.

• Website: medimpact.com
• Ownership type: Venture Capital
• Headquarters: San Diego, California, United States (USA)
• Employee distribution: United States (USA) 95%, Other 5%
• Latest funding: Seed, $1.4M, September 2013
• Founded year: 1989
• Headcount: 1001-5000
• LinkedIn: medimpact

MedImpact Healthcare Systems, Inc. is a pharmacy benefit manager based in San Diego, California, founded in 1989. The company was established by a pharmacist who recognized the challenges families faced with high prescription costs. MedImpact aims to make prescription benefits understandable and accessible, serving both consumers and businesses in the healthcare sector. With a workforce of approximately 1,800 employees, the company processes over $40 billion in pharmacy transactions each year and provides services to more than 20 million members. MedImpact offers a range of solutions, including home delivery of medications and a mobile app that helps members manage their prescriptions effectively. Their commitment to improving healthcare access and affordability is evident in their operations and member-focused initiatives.

4. Navitus Health Solutions

• Website: navitus.com
• Ownership type: Private
• Headquarters: Madison, Wisconsin, United States (USA)
• Employee distribution: United States (USA) 100%
• Founded year: 2003
• Headcount: 1001-5000
• LinkedIn: navitus-health-solutions

Navitus Health Solutions, based in Madison, Wisconsin, is a healthcare service provider that specializes in pharmacy benefit management (PBM). Established in 2003, the company was founded on the principle that the PBM model needed to evolve to better serve the needs of plan sponsors and individuals. Navitus operates with a distinctive 100% pass-through business model, which aims to drive down costs and improve access to prescription medications. This model is designed to ensure that clients receive the lowest net cost for their pharmacy benefits. The company is committed to helping individuals afford the medications they need, thereby enhancing their quality of life. Navitus serves a variety of clients, including members, plan sponsors, prescribers, and pharmacies, and has received accreditation from the National Committee for Quality Assurance (NCQA) and URAC, highlighting its commitment to quality and accountability in healthcare services.

5. RxBenefits, Inc.

• Website: rxbenefits.com
• Ownership type: Private Equity
• Headquarters: Birmingham, Alabama, United States (USA)
• Employee distribution: United States (USA) 92%, India 8%
• Latest funding: December 2020
• Founded year: 1995
• Headcount: 1001-5000
• LinkedIn: rxbenefits-inc-

RxBenefits, Inc., founded in 1995 and based in Birmingham, Alabama, is a pharmacy benefits management company that specializes in optimizing pharmacy benefits for employers and health systems. The company offers a range of services designed to help clients manage costs and enhance member access to medications. Their flagship solutions, Optimize 360 and RxBenefits Protect, are tailored to meet the needs of various clients, including benefits advisors, hospitals, and third-party administrators. RxBenefits focuses on delivering significant savings and exceptional service, with reported first-year savings of 28% or more for clients. The company operates primarily in the healthcare sector, demonstrating a commitment to improving the pharmacy benefits experience for both employers and their members. With a workforce of over 800 employees, RxBenefits is well-positioned to address the complexities of pharmacy benefits management.

6. Evernorth Health Services

• Website: evernorth.com
• Ownership type: Private
• Headquarters: St. Louis, Missouri, United States (USA)
• Employee distribution: United States (USA) 72%, India 27%
• Founded year: 2020
• Headcount: 10001+
• LinkedIn: evernorth

Evernorth Health Services, founded in 2020 and based in St. Louis, Missouri, is a health services provider that specializes in a variety of solutions, including pharmacy management, behavioral health services, and benefits management. The company collaborates with health plans, employers, and public sector organizations to enhance health outcomes and streamline care delivery. Evernorth's innovative strategies address the complexities of health care, making it more accessible and affordable for individuals and organizations. Notably, Evernorth operates Express Scripts, a prominent pharmacy benefit management service that caters to over 112 million Americans, showcasing its significant role in the pharmacy sector. The company is dedicated to creating integrated health solutions that not only focus on medication management but also consider the overall health and well-being of its members.

7. Optumrx Pharmacy, INC.

• Website: optumrx.com
• Ownership type: Private
• Headquarters: Trabuco Canyon, California, United States (USA)
• Employee distribution: United States (USA) 100%
• Founded year: 2015
• Headcount: 11-50
• LinkedIn: optumrx-pharmacy-inc.

OptumRx Pharmacy, INC., founded in 2015 and based in Trabuco Canyon, California, is a private healthcare service provider that specializes in pharmacy benefit management. The company offers a range of services designed to enhance medication accessibility and affordability for its clients. These services include home delivery pharmacy options, comprehensive drug pricing information, and medication therapy management. OptumRx aims to streamline the prescription process for both individuals and organizations, ensuring that patients receive their medications in a timely manner while also providing tools to help manage costs. With a workforce of approximately 402 employees, the company operates entirely within the United States, focusing on delivering quality healthcare solutions to its members.

8. WellDyne

• Website: welldyne.com
• Ownership type: Private Equity
• Headquarters: Lakeland, Florida, United States (USA)
• Employee distribution: United States (USA) 100%
• Latest funding: August 2016
• Founded year: 1990
• Headcount: 501-1000
• LinkedIn: welldynerx

WellDyne, based in Lakeland, Florida, is a healthcare service provider that specializes in pharmacy benefit management. Founded in 1990, the company has grown to serve over 3 million members and partners with more than 2,000 clients. WellDyne offers a range of services designed to optimize medication adherence and control healthcare costs. Their offerings include specialty pharmacy, mail order pharmacy, and clinical support programs, which are tailored to meet the needs of employers, health systems, and unions. The company emphasizes transparency in pricing and outcomes, aiming to provide clients with clear insights into their pharmacy benefits. WellDyne's innovative approach combines technology with clinical expertise to enhance member engagement and improve health outcomes. They have built a reputation for addressing the complexities of managing pharmacy benefits, particularly for patients with chronic conditions. With a capacity to fulfill over 15 million prescriptions annually, WellDyne is positioned as a significant player in the pharmacy benefit management industry.

9. Elixir

• Website: elixirsolutions.com
• Ownership type: Private
• Headquarters: Philadelphia, Pennsylvania, United States (USA)
• Employee distribution: United States (USA) 92%, India 4%, Other 4%
• Founded year: 2001
• Headcount: 1001-5000
• LinkedIn: elixir-craftedrxsolutions

Elixir, which has rebranded as MedImpact, is a healthcare services company based in Philadelphia, Pennsylvania. Founded in 2001, the company specializes in pharmacy benefits management, offering a variety of services designed to assist individuals and organizations in managing their prescription drug benefits. Elixir provides tools for prescription benefits management, mail order pharmacy services, and support for specialty medications. Their member portal allows users to access information about their coverage, find network pharmacies, and manage their prescriptions conveniently. With a workforce of over 600 employees, Elixir is positioned to deliver effective solutions in the pharmacy benefits space, catering to the needs of both consumers and healthcare providers.

10. Abarca Health

• Website: abarcahealth.com
• Ownership type: Private
• Headquarters: United States (USA)
• Employee distribution: Puerto Rico 81%, United States (USA) 19%
• Founded year: 2005
• Headcount: 501-1000
• LinkedIn: abarcahealth

Abarca Health is a pharmacy benefit manager and healthcare technology company founded in 2005, with a mission to transform the prescription experience. The company operates primarily in the United States and Puerto Rico, employing around 696 individuals. Abarca offers a range of services including pharmacy benefits management, advanced analytics, and cost management solutions tailored for private and public sector plans, self-insured employers, and other pharmacy benefit managers. Their proprietary platform, Darwin™, is designed to enhance user experience and streamline complex benefit designs. Abarca is committed to transparency in pricing and has developed innovative strategies to manage drug spending effectively. They process over 100 million prescription claims annually and serve approximately 5.3 million lives, showcasing their significant impact in the healthcare sector.

11. PerformRx

• Website: performrx.com
• Ownership type: Private
• Headquarters: United States (USA)
• Employee distribution: United States (USA) 100%
• Founded year: 1999
• Headcount: 201-500
• LinkedIn: performrx

PerformRx is a private Pharmacy Benefit Manager (PBM) based in the United States, founded in 1999. The company specializes in providing comprehensive pharmacy benefit management services, particularly for managed care organizations, Medicaid, and Medicare clients. With a workforce of approximately 277 employees, PerformRx focuses on enhancing health outcomes while simultaneously reducing healthcare costs through customized clinical services and drug therapy management. Their offerings include formulary management, drug utilization review, and a robust drug therapy management program, all designed to meet the specific needs of their clients. PerformRx has built a reputation for transparency in pricing and strategic alignment with client goals, ensuring that their services are tailored to the unique requirements of each organization they serve. They have also developed proprietary technology platforms to support their operations and adapt to regulatory changes, further solidifying their role in the pharmacy benefit management industry.

12. Benecard Services, LLC

• Website: benecard.com
• Ownership type: Private
• Headquarters: Lawrence Township, New Jersey, United States (USA)
• Employee distribution: United States (USA) 100%
• Founded year: 1990
• Headcount: 51-200
• LinkedIn: benecard-services-llc

Benecard Services, LLC, based in Lawrence Township, New Jersey, is a private healthcare service provider specializing in prescription benefit management. Since its inception in 1990, the company has focused on delivering customized benefit programs to both private and public sector organizations, catering to groups ranging from 100 to over 5,000 members. Benecard's offerings include a unique Rx Budget Guarantee, which protects clients from unexpected costs, and a comprehensive clinical package aimed at enhancing member safety and adherence to prescribed therapies. Their services are designed to streamline the administration of prescription benefits while ensuring high-quality care for members. The company operates an in-house mail and specialty pharmacy, further enhancing its service capabilities. With a strong emphasis on client satisfaction, Benecard has consistently ranked well in customer satisfaction surveys, reflecting their commitment to providing effective and reliable pharmacy benefit solutions.

13. Maxor National Pharmacy Services, LLC

• Website: maxor.com
• Ownership type: Corporate
• Headquarters: Plano, Texas, United States (USA)
• Employee distribution: United States (USA) 100%
• Latest funding: January 2014
• Founded year: 1926
• Headcount: 1001-5000
• LinkedIn: maxor-national-pharmacy-services-corp-

Maxor National Pharmacy Services, LLC is a healthcare management company based in Plano, Texas, specializing in pharmacy services. Founded in 1926, Maxor has evolved from a single pharmacy into a multifaceted organization that provides pharmacy benefit management, specialty pharmacy services, and comprehensive pharmacy management solutions. The company operates through several divisions, including MaxorPlus, Maxor Specialty, and Maxor Pharmacy Services, each designed to enhance operational efficiency and patient care for healthcare providers and organizations. With a workforce of over 1,000 employees, Maxor is dedicated to transforming pharmacy care by integrating advanced technology and fostering collaboration among pharmacies, providers, and patients. Their commitment to improving healthcare outcomes is evident in their tailored solutions that address the complexities of pharmacy management, including compliance with the 340B program. Maxor's extensive experience and innovative approach position it as a significant player in the pharmacy services industry.

14. Capital Rx

• Website: cap-rx.com
• Ownership type: Private
• Headquarters: New York, New York, United States (USA)
• Employee distribution: United States (USA) 100%
• Founded year: 2017
• Headcount: 501-1000
• LinkedIn: cap-rx

Capital Rx, founded in 2017 and based in New York City, is a healthtech company that specializes in pharmacy benefits management (PBM). The company aims to transform how prescriptions are priced and how patients receive care, focusing on transparency and cost savings. Capital Rx offers a full-service PBM solution tailored for self-funded plan sponsors, as well as an unbundled option for larger employers. Their proprietary platform, JUDI®, integrates various pharmacy operations into a single, efficient system, enhancing operational efficiency and client experience. The company has garnered a reputation for its commitment to reducing administrative costs and improving patient outcomes. With a strong emphasis on customer service, Capital Rx has achieved high client satisfaction and retention rates, further solidifying its position in the pharmacy benefits industry.

15. ProCare Rx

• Website: procarerx.com
• Ownership type: Private
• Headquarters: Gainesville, Florida, United States (USA)
• Employee distribution: United States (USA) 95%, Georgia 3%, Other 2%
• Founded year: 1988
• Headcount: 201-500
• LinkedIn: procare-rx

ProCare Rx, based in Gainesville, Florida, is a private healthcare technology provider that specializes in pharmacy benefit management (PBM). Established in 1988, the company has built a reputation for offering a range of services designed to optimize pharmacy benefits and manage costs effectively for healthcare entities. Their core offerings include pharmacy claims processing, rebate administration, and advanced data analytics tools. ProCare Rx's technology is utilized by thousands of clients to manage millions of members' prescription data, showcasing their operational scale and industry impact. The company emphasizes integrity and high-quality customer service, which is reflected in their Seal of Commitment—a brand promise that underscores their dedication to clients and the industry. ProCare Rx also collaborates with affiliated companies to enhance their service offerings, further solidifying their role in the pharmacy benefit management sector.

16. MyMatrixx by Evernorth

• Website: mymatrixx.com
• Ownership type: Corporate
• Headquarters: Tampa, Florida, United States (USA)
• Employee distribution: United States (USA) 100%
• Latest funding: $250.0M, May 2017
• Founded year: 2001
• Headcount: 201-500
• LinkedIn: mymatrixx

MyMatrixx by Evernorth, founded in 2001 and based in Tampa, Florida, operates as a pharmacy benefit manager with a distinct emphasis on workers' compensation. The company provides a range of services designed to assist insurance carriers and employers in managing pharmacy benefits for injured workers. Their offerings include clinical management programs, data analytics, and advanced technology solutions aimed at ensuring appropriate medication management while controlling costs. MyMatrixx is dedicated to enhancing patient outcomes through tailored pharmacy solutions, which are critical in the context of workers' compensation. The company has received significant funding, amounting to $250 million in 2017, which underscores its potential for growth and innovation in the pharmacy benefit management sector. MyMatrixx's commitment to clinical excellence and proactive management strategies positions it as a noteworthy player in the pharmacy benefit management industry.

17. Citizens Rx

• Website: citizensrx.com
• Ownership type: Private Equity
• Headquarters: Oak Park, Illinois, United States (USA)
• Employee distribution: United States (USA) 100%
• Latest funding: February 2019
• Founded year: 2009
• Headcount: 51-200
• LinkedIn: citizens-rx

Citizens Rx, founded in 2009 and based in Oak Park, Illinois, is a healthcare consulting firm that specializes in pharmacy benefit management (PBM) services. The company provides a range of solutions designed to help health plans and employers manage their drug spending effectively. Their offerings include formulary management, real-time claims processing, clinical services, and rebate administration. Citizens Rx emphasizes a modular approach, allowing clients to select services that best fit their specific needs. The firm prides itself on its commitment to service excellence, flexibility, and the ability to deliver significant cost savings through customized plan designs. With a dedicated team of experienced professionals, Citizens Rx aims to enhance the member experience while ensuring that clients understand their options and make informed decisions regarding their pharmacy benefits.

18. Pharmacy Benefit Dimensions

• Website: pbdrx.com
• Ownership type: Private
• Headquarters: Buffalo, New York, United States (USA)
• Employee distribution: United States (USA) 96%, Canada 4%
• Founded year: 1998
• Headcount: 51-200
• LinkedIn: pharmacy-benefit-dimensions

Pharmacy Benefit Dimensions (PBD), based in Buffalo, New York, is a private pharmacy benefit management company founded in 1998. With a workforce of approximately 83 employees, PBD specializes in managing prescription drug benefits for individuals, families, and employers. The company offers a variety of services, including specialty medications, mail-order pharmacy services, and medication therapy management. PBD aims to provide valuable resources and support to help clients navigate their healthcare needs effectively. Their commitment to quality is highlighted by their URAC accreditation, which recognizes their efforts in improving processes and patient outcomes. PBD primarily serves clients in the United States, with a small percentage of operations in Canada, and has established itself as a reliable partner in the pharmacy benefit management sector.

19. Truveris

• Website: truveris.com
• Ownership type: Venture Capital
• Headquarters: Wilmington, Delaware, United States (USA)
• Employee distribution: United States (USA) 100%
• Latest funding: Series E-K, $15.0M, May 2024
• Founded year: 2009
• Headcount: 51-200
• LinkedIn: truveris

Truveris, founded in 2009 and based in Wilmington, Delaware, is a company that specializes in pharmacy benefits management. The firm offers a range of solutions designed to optimize pharmacy benefits for employers and benefits brokers. Their services include contract oversight, plan procurement, and member engagement tools, all aimed at reducing costs and improving access to medications. Truveris employs a technology-driven approach that emphasizes transparency and efficiency in managing pharmacy benefits. The company has analyzed millions of claims and managed billions in drug spend, showcasing its significant impact in the industry. Recently, Truveris secured $15 million in a Series E-K funding round in May 2024, further solidifying its position and capacity for growth in the pharmacy benefits space.

20. Independent Health

• Website: independenthealth.com
• Ownership type: Private
• Headquarters: Buffalo, New York, United States (USA)
• Employee distribution: United States (USA) 94%, Other 6%
• Founded year: 1980
• Headcount: 1001-5000
• LinkedIn: independent-health

Independent Health, founded in 1980 and based in Buffalo, New York, is a private health insurance provider that serves individuals, families, and employers. The company offers a range of health insurance plans, including Medicare options, and is involved in pharmacy benefit management through its Pharmacy Benefit Dimensions platform. This platform provides essential services such as drug formulary management, medication therapy management, and tools to help members understand their prescription drug benefits. With a workforce of approximately 1,777 employees, Independent Health aims to improve health outcomes and manage healthcare expenses effectively for its members. The company has not reported any recent funding, indicating a stable operational model without external financial backing.

21. RxSense

• Website: rxsense.com
• Ownership type: Private Equity
• Headquarters: Boston, Massachusetts, United States (USA)
• Employee distribution: United States (USA) 97%, India 3%
• Latest funding: May 2020
• Founded year: 2015
• Headcount: 201-500
• LinkedIn: rxsense

RxSense is a healthcare technology company based in Boston, Massachusetts, founded in 2015. The company specializes in pharmacy benefit management and prescription savings, providing innovative solutions designed to enhance access to affordable medications. Their product offerings include discount cards, integrated benefits, and advanced analytics platforms, all aimed at improving operational efficiency for businesses in the healthcare sector. RxSense serves a variety of clients, including pharmacy benefit managers, pharmacies, and consumers, leveraging technology to optimize pharmacy benefits. Notably, they operate the SingleCare brand, which facilitates direct-to-consumer prescription savings. The company has received recognition for its workplace culture and innovation, being named one of America's Best Startup Employers by Forbes in 2024 and earning accolades from Modern Healthcare. With a workforce of over 350 employees, RxSense is positioned to make a significant impact in the pharmacy benefit management space.

22. BeneCard PBF

• Website: benecardpbf.com
• Ownership type: Private
• Headquarters: Bonita Springs, Florida, United States (USA)
• Employee distribution: United States (USA) 100%
• Founded year: 2008
• Headcount: 201-500
• LinkedIn: benecardpbf

BeneCard PBF, founded in 2008 and based in Bonita Springs, Florida, is a privately owned pharmacy benefit manager (PBM) dedicated to enhancing healthcare outcomes while reducing prescription drug costs. With a workforce of approximately 315 employees, the company emphasizes a patient-first approach, offering services such as real-time drug pricing tools, clinical reviews, and personalized care tailored to the needs of members, clients, and healthcare professionals. BeneCard PBF operates with a strong commitment to ethics and transparency, ensuring that their pricing structures are clear and auditable. They have developed innovative programs like BenePrecise Pharmacogenetics and The Green Plan, which reflect their focus on clinical excellence and cost savings. Their model is designed to challenge traditional PBM practices, aiming to provide a more ethical and effective healthcare experience.

Pharmacy Benefit Management Insights: Key Companies in the US

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